Onboarding New Therapy Team Members

By Lisa Brook, DOR, St. Joseph Villa, Salt Lake City, Utah
Lisa Brook, DOR at St. Joseph Villa, recently shared their new therapist/new employee training and mentorship process. As COVID continues to de-escalate, their team is beginning to focus again on leadership development and believe this process starts from the very beginning of employment at St. Joe’s. They are attempting to be more intentional about onboarding and training of new therapists as their skilled census grows and they are expanding their outpatient programing as well as their LTC programing. The therapy team at St. Joe’s is being more intentional about the hiring process with improved communication with Jamie Funk, involvement of key staff in the interview process and then setting more specific plans for the onboarding and training process. In order to grow leaders we must start with growing good therapists, mindful of their treatment approaches, seeking to make the most of their time. Lisa walked us through their onboarding process:

Day 1: NetHealth email sent to the staff early in the a.m. of the first day of a new therapist’s arrival that introduces him/her so that everyone knows the person by name. On this day, the new therapist is assigned to a therapist of the same discipline just to observe. This is planned ahead of time so the therapists are aware they will have someone shadowing them that day. We encourage the new therapist to take notes as we go through the login process for NetHealth, PCC, tour the building, meet members of the leadership team, observe the pace of things, etc. The first day is usually only a half day.

Day 2-3: Again, these are usually not full days. The new employee treats two or three patients on our skilled rehab unit. Their schedule is loaded with patients who will cooperate and give them a “win” for the day. The goal is to feel comfortable with the patients and just be a therapist! At the end of those treatments, they will spend time verbally reviewing the treatment, patient response to treatment, and potential documentation with the same therapist they shadowed with on Day 1. They do their billing, write their TENs, and then the therapist reviews and they discuss necessary corrections.

Day 4 and on: As the new therapists get more comfortable, more patients are added to their caseload. They treat patients on our skilled rehab unit and start to initiate point of service documentation. Time is scheduled with their “mentoring” therapist to answer questions and review documentation and goals. This process has been helpful for new employees, and they look forward to it as it gives them an opportunity to get all their questions answered in a more in-depth manner.

Next Steps: Next steps are really driven by the new team member. We initiate writing progress notes during week 2 for a new graduate and then add other necessary documentation as they begin to have success. As the DOR, Lisa said she checks in with them each day, but this process allows the experienced staff to take ownership of our training/onboarding process, and it seems to be working! Lisa said that even if they hired an experienced therapist rather than a new grad, there is still a lot of mentoring that we need to provide. They consider the confidence level of the therapist and tweak the process as needed. As they add more patients to their caseload, we have ongoing conversations.

Variables to Consider: New grads often require more mentoring. However, experienced therapists, part-time/PRN staff should always be provided an opportunity to receive mentorship as needed. Consideration must also be given to the confidence level of the individual. It often takes as much “coaching” for a seasoned therapist to get acclimated to treatment approaches, writing appropriate goals and skilled TENS because there are some differences in documentation in each subset of our programming (skilled rehab, skilled maintenance, outpatient, sub-acute respiratory, LTC).

Lisa said we need to allow our therapists time to grow. If we are going to create leaders, we need to be intentional about onboarding and training. We want them to be confident in their skills and critical thinking and be leaders among their peers in the building. Jamie added that Lisa has done an amazing job! St. Joseph Villa has a reputation in the community of empowering their therapists in establishing plan of care and treatment approaches to fit the needs of the community. She has heard from candidates that they know how great it is to work at St. Joseph’s, and all of the tools Lisa shared with us are having an enormous impact in growing therapists to be outstanding clinicians, leaders in St. Joe’s and then leaders beyond St. Joe’s.